Tribune

From left to right. Dr. Grady “Sam” Hogue, the interim department head of primary care and population health with the Texas A&M College of Medicine, Lorenzo Serrano, the chief executive officer of Winkler County Memorial Hospital, and Dr. Diedra Wuenschel, a doctor of osteopathic medicine at Coryell Health in Gatesville, discuss the state of health care in rural Texas during an event at Temple College on Wednesday. 

Dr. Diedra Wuenschel, a doctor of osteopathic medicine at Coryell Health in Gatesville, has a passion for serving residents in rural Texas.

“I started in Gatesville 10 years ago because I wanted to practice family medicine full spectrum,” she said. “I see patients from birth to death, in the clinic, in the nursing home and in the hospital. It’s been a great opportunity seeing people live their lives.”

That impact is exactly why Wuenschel entered the world of medicine.

“I wanted to go there and make a difference and show people how we can help them in multiple ways,” she said.

However, Wuenschel, who also serves rural residents in Mills County, detailed how COVID-19 challenged that mission during a “conversation event” hosted by The Texas Tribune on Wednesday in the Temple College Academic Center — an event that also featured Dr. Grady “Sam” Hogue, the interim department head of primary care and population health with the Texas A&M College of Medicine, and Lorenzo Serrano, the chief executive officer of Winkler County Memorial Hospital.

Each of the trio offered anecdotal stories about their experiences from the past two years.

“It’s always been tough to challenge the staff of a hospital. On top of COVID, you had an increase in patients and you had fear from the medical staff meant to treat COVID patients,” Serrano, whose hospital has fewer than 100 employees, said. “We had to be very creative, very innovative on how we can keep our staff safe.”

That goal, Serrano stressed, required his staff and other health care providers in rural Texas to completely redesign how they operate.

“There was not one part of the organization that wasn’t impacted,” he said.

Although medical facilities all throughout the United States in the world were impacted by COVID-19, Serrano noted how many rural health care providers often faced greater or different burdens.

“The standard of care in rural hospitals is the same as your urban markets. It has to be the same,” he said. “We just have to figure out how to do that with less staff, less resources and less financial resources.”

One of those resources was internet access.

“We tried to do telehealth in a traditional way. Unfortunately, we quickly learned that it just wasn’t going to work,” Serrano said. “So we switched over just to phone visits ... old school.”

Another challenge was overcoming a lack of trust.

“I get it. The (Centers for Disease Control and Prevention) was changing their own recommendations and backing up,” Hogue said. “People that were very highly motivated got the vaccine, but when you look at the underserved communities … they did not want to go to those public health vaccines. There was a lack of trust. So we had to be innovative and go talk with stakeholders.”

That mindset for some began to change when a loved one died after contracting COVID-19.

“I remember when I went out to one of the Baptist churches, an African-American church,” Hogue said. “The large majority were getting the (COVID-19) vaccine because their loved ones died. I can’t tell you how distressing it was.”

Serrano — the vice chair on the board of directors for the Texas Organization of Rural and Community Hospitals and chair of the Texas Hospital Association’s rural hospital council — highlighted how a sense of normalcy has only recently returned to his facility.

“We weren’t in crisis mode but now we have to do all of the projects that we delayed for two years,” he said.

Wuenschel had similar experiences but noted the support from her community.

“The majority of our population were bringing us gloves. They were bringing us snacks. They were saying thank you for doing everything,” she said. “I mean, they wanted us to be safe because we’re their family and their friends.”

Serrano, like his peers, was thankful for the opportunity as rural hospital leaders to have a platform to tell their stories.

“I think rural hospitals have made some big impact on the community and what we can do,” he told the Telegram. “I think we saw the community appreciate local hospitals much more throughout the pandemic … and I think that is certainly going to be the case moving forward.”